Publication: Treating pulmonary embolism in Pacific Asia with direct oral anticoagulants
Issued Date
2015-08-01
Resource Type
ISSN
18792472
00493848
00493848
Other identifier(s)
2-s2.0-84938550330
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Mahidol University
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SCOPUS
Bibliographic Citation
Thrombosis Research. Vol.136, No.2 (2015), 196-207
Suggested Citation
Alexander Cohen, Sinnadurai Jeyaindran, Jae Yeol Kim, Kihyuk Park, Suree Sompradeekul, Karmel L. Tambunan, Huyen Tran, I. Chen Tsai, Christopher Ward, Raymond Wong Treating pulmonary embolism in Pacific Asia with direct oral anticoagulants. Thrombosis Research. Vol.136, No.2 (2015), 196-207. doi:10.1016/j.thromres.2015.05.024 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/36368
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Title
Treating pulmonary embolism in Pacific Asia with direct oral anticoagulants
Other Contributor(s)
Guy's and St Thomas' NHS Foundation Trust
Kuala Lumpur Hospital
Chung-Ang University, College of Medicine
Daegu Catholic University Hospital
Mahidol University
Universitas Indonesia
Alfred Hospital
Monash University
Show-Chwan Memorial Hospital Taiwan
Kolling Institute of Medical Research
Prince of Wales Hospital Hong Kong
Kuala Lumpur Hospital
Chung-Ang University, College of Medicine
Daegu Catholic University Hospital
Mahidol University
Universitas Indonesia
Alfred Hospital
Monash University
Show-Chwan Memorial Hospital Taiwan
Kolling Institute of Medical Research
Prince of Wales Hospital Hong Kong
Abstract
© 2015 Elsevier Ltd. All rights reserved. Pulmonary embolism (PE) is the principal preventable cause of in-hospital deaths. Prevalence of PE in Asians is uncertain but undoubtedly underestimated. Asians and Caucasians have similar non-genetic risk factors for PE, and there is mounting evidence that PE affects Asians much more commonly than previously supposed; incidence, especially among high-risk patients, may approach that in Caucasians. Furthermore, PE incidence in Asia is increasing, due to both increased ascertainment, and also population ageing and growing numbers of patients with predisposing risk factors. Despite being warranted, thromboprophylaxis for high-risk patients is not routine in Pacific Asian countries/regions. There also appears to be scope to implement venous thromboembolism (VTE) management guidelines more assiduously. Anticoagulants, primarily heparins and warfarin, have been the mainstays of VTE management for years; however, these agents have limitations that complicate routine use. The complexity of current guidelines has been another barrier to applying evidence-based recommendations in everyday practice. Updated management approaches have considerable potential to improve outcomes. New oral anticoagulants that are easier to administer, require no, or much less, monitoring or dose-adjustment and have a favourable risk/benefit profile compared with conventional modalities, may offer an alternative with the potential to simplify VTE management. However, more information is required on practical management and the occurrence and treatment of bleeding complications. Increasing recognition of the burden of PE and new therapeutic modalities are altering the VTE management landscape in Pacific Asia. Consequently, there is a need to further raise awareness and bridge gaps between the latest evidence and clinical practice.